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Ultrasound of the Month – Case 19

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Discussion The patient also reports less severe but similar contralateral symptoms.

Ultrasound of the Month – Case 19

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Ultrasound of the Month – Case 19

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Ultrasound of the Month – Case 19

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Diagnosis Calcific tendinosis of the long head of the rectus femoris tendon at the Anterior Inferior Iliac Spine.

Ultrasound of the Month – Case 19

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Discussion Calcific tendinosis is most commonly seen in the rotator cuff of the shoulder but can occur within any tendon. The material deposited is calcium hydroxyapatite. This is a distinct entity from enthesopathic change at tendon attachments to bone.

Ultrasound of the Month – Case 19

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Treatment Options • • • •

Conservative treatment (pain relievers, physical therapy) Extracorporeal Shock Wave Therapy Surgery Ultrasound-guided calcium lavage and aspiration

Ultrasound of the Month – Case 19

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Ultrasound-Guided Calcium Lavage and Aspiration • • •

18 gauge needle is advanced into the focus of calcium with sonographic guidance Calcific material is aspirated if possible Lavage with saline and anesthetic is performed to free calcific material and allow aspiration of additional calcium

Ultrasound of the Month – Case 19

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Ultrasound of the Month – Case 19

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Follow up 2 months following the ultrasound-guided calcium aspiration, the patient reported essentially complete pain relief and improved range of motion of the right hip.

Ultrasound of the Month – Case 19

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Hospital For Special Surgery: Ultrasound of the Month - Case 19